Embryo obtained after in vitro fertilisation (five days after in vitro fertilisation and culture). © Prof. P. Fauque, Dijon University Hospital

Inserm scientists from the Epidemiology of Childhood and Adolescent Cancers team (EPICEA – Inserm JRU 1153)[1] and the EPI-PHARE scientific interest group (ANSM/Cnam), together with experts in medically assisted reproduction (MAR), have published in JAMA Network Open the findings of a large-scale study aimed at comparing the risk of cancer in children conceived by MAR with that of children conceived naturally. Involving over 8.5 million children born in France between 2010 and 2021, this is one of the largest studies conducted to date on the risk of cancer in children conceived by MAR.

Although the study does not show an increased overall risk of cancer among children born after MAR, it does suggest a very slight increase in their risk of leukaemia.

MAR concerns approximately 1 in 30 births in France (see box). The available data, which remain limited and heterogeneous, have suggested increased risks of certain health conditions, including cancers, among children conceived through it. Large-scale evaluation of the cancer risk is essential and constitutes a priority research objective, as a recent report from the French National Academy of Medicine shows[2].

Scientists from Inserm and EPI-PHARE, in conjunction with specialists in MAR, evaluated this cancer risk in one of the world’s largest cohorts of children born after MAR.

They used data from the French National Health Data System (SNDS)[3] to identify children conceived by MAR (artificial insemination, conventional in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI)) and to detect the onset of cancer in children conceived with or without the use of MAR.

All in all, the study concerned the 8 526 306 children born in France between 2010 and 2021, of whom 260 236 (3%) were conceived by MAR, and followed them up to a median age of 6.7 years.

During this follow-up, 9 256 children, including 292 conceived by MAR, developed cancer. The overall risk of cancer was no higher in the children conceived by MAR than in those conceived naturally.

However, a slight increase in leukaemia risk was observed in the children conceived by IVF or ICSI. This increase is very small – representing one additional case per 5 000 newborns conceived by IVF or ICSI having reached 10 years of age – and requires confirmation.

While the absence of an increased overall risk of cancer is reassuring, the epidemiological monitoring will be continued in order to better evaluate the cancer risk over the longer term. It is also necessary to continue research efforts in order to understand which mechanisms related to MAR techniques or parental fertility disorders could induce the increased risk of leukaemia, should this be confirmed.

This study received funding from the ANSM.

[1] The team is based at the Centre for Research in Epidemiology and Statistics – CRESS (Inserm/Université Paris Cité).

[2] Jouannet P, Claris O, Le Bouc Y. Rapport 23-07. Santé à moyen et à long terme des enfants conçus par fécondation in vitro (FIV). Bull Acad Ntle Med 2023; 207: 695-705.

[3] The SNDS, which groups France’s main existing public health databases, aims to improve knowledge of medical care and broaden the scope of research, studies and evaluations in the field of health.

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